1. ¹Department of Tumor Diagnostics and Therapy, Paracelsus Hospital, Osnabrueck, Germany
2. ²Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
3. ³Coordination Centre for Clinical Trials, Heidelberg, Germany
4. ⁴Department G402, Pharmacology of Cancer Treatment, German Cancer Research Center, Heidelberg, Germany
5. ⁵Department of Radiation Oncology, Mannheim Medical Center, University of Heidelberg, Mannheim, Germany

Correspondence: Professor Dr S Fruehauf, Department of Tumor Diagnostics and Therapy, Paracelsus Hospital, Am Natruper Holz 69, 49076 Osnabrueck, Germany. E-mail: prof.stefan.fruehauf@pk-mx.de

Received 5 July 2006; Revised 8 March 2007; Accepted 14 March 2007; Published online 23 April 2007.

Abstract

High-dose chemotherapy followed by autologous blood stem cell transplantation is the standard treatment for myeloma patients. In this study, CAD (cyclophosphamide, adriamycin, dexamethasone) chemotherapy and a single dose of pegfilgrastim (12 mg) was highly effective in mobilizing peripheral blood stem cells (PBSCs) for subsequent transplantation, with 88% of patients (n=26) achieving the CD34⁺ cell harvest target of 7.50 10⁶ CD34⁺ cells/kg body weight, following a median of two apheresis procedures (range 1–4) and with first apheresis performed at a median day 13 after CAD application (range 10–20). Patients treated with pegfilgrastim showed a reduced time to first apheresis procedure from mobilization compared with filgrastim-mobilized historical matched controls (n=52, P=0.015). The pegfilgrastim mobilization regimen allowed for transplantation of a median of 3.58 10⁶ CD34⁺ cells/kg body weight while leaving sufficient stored cells for a second high-dose regimen and back-ups in most patients. Engraftment following transplantation was comparable to filgrastim, with a median time of 14 days to leucocyte 1.0 10⁹/l (range 10–21) and 11 days to platelets 20 10⁹/l (range 0–15). The results of this study thus provide further support for the clinical utility of pegfilgrastim for the mobilization of PBSC following chemotherapy in cancer patients scheduled for transplantation.